Client Information Verification

Please Verify Your Account Information

This will help us serve you better by giving you updates on products and services. Thank You!

Verifying our client account information will help us better serve you. Updated information allows us to provide updates on products and services you have with us. We can inform you of new products and services provided by XBS Digital and our technology partners.

Billing Contact's Information

Company Name *

Parent Company or Legal Name?

Company Website Address:

Billing Contact Name: *

First

Last

Billing Contact Email: *

Please add additional emails in the comments box at the bottom of the form.

Billing Contact Phone: *

Contact in Charge of Equipment or Services

Equipment Contact Name: *

First

Last

Equipment Contact Email: *

Equipment Contact Phone:

Mobile Phone:

Company's MAIN Address

Company Address: *

Suite or Bldg #:

City: *

State / Region: *

Zip / Postal Code: *

Would you like us to contact you?

Method of Contact?

Person's Name to be Contacted:

Please include any additional comments, questions or concerns below.

Website

(800) 676-4365